#110 Noncontraceptive Uses of Hormonal Contraceptives Flashcards
What percentage of US women will use hormonal contraception during their reproductive years?
> 80%
In combined hormonal contraceptives, what is the role of the progestin and what is the role of the estrogen?
Progestin provides contraceptive effects. Estrogen stabilizes endometrium and reduces unwanted spotting.
Which progestins in COCs have antiandrogenic properties?
Drospirenone and cyproterone acetate
Which type of COC best prevents the development of benign ovarian cysts?
High-dose monophasic preparations (compared to low dose and triphasic)
What are some non contraceptive benefits of OCPs and contraceptive patch
regulate and reduce bleeding, diminish dysmenorrhea, improved acne
True or false, extended cycle patch can be used to reduce menstrual cycle-related side effects such as menstrual migraine?
True
What noncontraceptive benefits does the levonorgestrel IUD have?
Decreased menstrual bleeding and dysmenorreha. Effective for decreasing menstrual blood loss in idiopathic menorrhagia, adenomyosis, leiomyomas, pain d/t endometriosis, and hemostatic disorders
What causes dysmenorrhea?
Pain resulting from intense uterine contractions that are triggered by release of endometrial prostaglandins
Which hormonal contraceptives are beneficial for treatment of dysmenorrhea?
COCs (relieve symptoms in up to 70-80% of women), vaginal ring, Progestin implant (nexplanon), levonorgestrel IUD
What hormonal contraceptives have shown to be effective in reducing endometriosis pain?
COCs, DMPA, progestin contraceptive implant, levonorgestrel IUD
What is the reduction in menstrual blood loss in women taking cyclic COCs?
Reduced by 40-50%
What is rate of amenorrhea after 12 months of levonogestrel IUD?
20-80%
Is the levonorgestrel IUD or COCs more effective for treatment of heavy menstrual bleeding?
Levonorgestrel IUD
Is endometrial ablation or levonorgestrel IUD better at reducing menstrual blood loss up to 24 months?
Similar reduction
How common is premenstrual dysphoric disorder?
Affects 3-5% of reproductive aged women
Which progestin has been associated with improvement in premenstrual dysphoric disorder?
Drospirenone
How many women experience menstrual migraines?
8-14%
When do menstrual migraines occur?
At the time of menstruation, otherwise free of migraines, with exception of small percentage with migraine at time of ovulation
What can be hormonal option can be used for women with menstrual migraines?
Extended cycle or continuous COCs
Which hormonal contraceptives are effective for treatment of hirsutism and acne?
All COCs have the potential. Some trials show superiority of antiandrogenic progestins (drospirenone or cyproterone acetate)
Mechanism of action that COCs improve acne/hirsutism?
Increase sex hormone binding globulin and suppress LH-driven ovarian androgen production, decreasing levels of free androgen
Does the use of COCs decrease risk of endometrial cancer?
Yes, by 50%. Longer durations of use were associated with greater decrease in risk. Effect lasts up to 20 years.
Does depot medroxyprogesterone acetate reduce the risk of endometrial cancer?
Yes
In what percentage of cases of endometrial hyperplasia without atypia does the levonorgesterel IUD cause regression?
96%
Does the levonorgesterel IUD protect the endometrium in women taking tamoxifen?
Yes
Does the use of COCs decrease the risk of ovarian cancer?
Yes, by 27%. The longer the use, the greater the risk reduction
Does the use of COCs decrease the risk of colorectal cancer?
Yes, by 18%. Greatest reduction for recent use and no duration effect
Does use of COCs hasten the resolution of functional ovarian cysts compared to expectant management?
No
What effects do COCs have on leiomyoma formation and growth?
Unknown
In which population does use of COCs preserve bone mass where non users lost BMD?
Perimenopausal and postmenopausal women
Is DMPA associated with increased risk of low BMD compared to peers?
No, can have lower BMD during use, but is rapidly recovered after discontinuation
